But most support many parts of health care reform law

THURSDAY, May 5, 2016 (HealthDay News) -- Six years after the introduction of Obamacare, Americans are still divided over the controversial health reform law even though most tend to support many parts of the measure, a new HealthDay/Harris Poll found.

However, none of the current crop of presidential candidates appears to inspire much hope that they'll properly handle health care policy if elected, the poll results show.

Only 28 percent of U.S. adults have a "great deal" or "some confidence" that Donald Trump could successfully manage the nation's health care policy, and only 30 percent feel the same way about Ted Cruz, who abandoned his campaign Tuesday night.

As for the Democratic candidates, about 44 percent of Americans have a "great deal" or "some confidence" in Hillary Clinton, while Bernie Sanders -- at 47 percent -- inspires the most confidence.

"While attitudes about the ACA (Affordable Care Act) remain divided and highly polarized by party, several key elements of it continue to enjoy the support of most people -- including the regulations relating to pre-existing conditions, the employer mandate and the expansion of Medicaid," said Humphrey Taylor, chairman emeritus of The Harris Poll. "However, the individual mandate is still very unpopular."

Support for the Affordable Care Act remains about the same as it has been since President Barack Obama signed it into law in 2010. About 23 percent of Americans want to keep it as it is, and another 30 percent would like to see the law kept but tweaked. About 33 percent call for repeal of the law.

But attitudes toward individual parts of the law vary greatly:

74 percent, including 62 percent of Republicans, want to keep the ACA rule that requires insurers to cover people with pre-existing medical conditions.

A more modest 51 percent favor keeping the ACA provision of subsidies to enable people with low incomes to buy insurance.

A similar 53 percent favor keeping the rule requiring employers with more than 50 full-time employees to provide them with insurance.

Only 41 percent favor keeping the rule increasing the numbers of people eligible for Medicaid.

However, 64 percent would like to repeal the ACA's "individual mandate," which requires most people to have insurance or pay a penalty.

The amount of political opposition on the national level inspired by the Affordable Care Act likely has caused opinions to harden, even though the benefits of the law have proven popular, said Ron Pollack, founding executive director of Families USA, a nonprofit health care consumer advocacy group.

"The debate about the Affordable Care Act has been sufficiently contentious that often people have strong viewpoints even if they do not yet understand what is in the legislation," Pollack said. "We have seen responses that support virtually all of the major provisions of the ACA, and people think those things are very valuable to them, but they have ambiguity over whether they support the ACA itself."

The continued opposition to the individual mandate reflects the public's general distaste for any mandate or additional tax, Pollack said.

"A lot of people are not fully aware of why the mandate is really essential in any program that expands [health insurance] coverage to people with pre-existing conditions," he said. "Without the mandate, if there's greater accessibility to coverage, a fair number of people may say, 'I'm not going to pay for coverage until I get sick or have an accident.' Were that to occur, premiums would skyrocket. I'm not sure many people have thought of that."

Given that the poll results reflect more national confidence in Democrats than Republicans regarding health care policy, Pollack said the coming election might see the end of the longstanding Obamacare debate.

"If the November elections turn out to be such that Hillary Clinton becomes president, I think the contentiousness that has existed for quite a few years is going to diminish, and there won't be any credible sense that the ACA should be or can be repealed," he said.

The HealthDay/Harris Poll was conducted online, in English, within the United States between April 15 and 19 among slightly more than 2,000 adults.

Figures for age, sex, race/ethnicity, education, region and household income were weighted where necessary to bring them into line with their actual proportions in the population. "Propensity score weighting" was also used, to adjust for respondents' propensity to be online.